Provider Demographics
NPI:1598840837
Name:GARRIDO, DIANA MARGARITA (PT)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:MARGARITA
Last Name:GARRIDO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8635 QUEENS BLVD
Mailing Address - Street 2:APT# 3E
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4434
Mailing Address - Country:US
Mailing Address - Phone:718-457-2361
Mailing Address - Fax:
Practice Address - Street 1:760 BROADWAY
Practice Address - Street 2:2B-261
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-5317
Practice Address - Country:US
Practice Address - Phone:718-963-8003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022814-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist